Gastroenteritis

Show Terms

Health Issues

Tobacco

Gastroenteritis
Questions & answers
Resources

Published by Bupa’s Health Information Team, August 2010.

This factsheet is for people who have gastroenteritis, or who would like information about it.

Gastroenteritis is inflammation of the stomach or bowels that is caused by an infection.

About gastroenteritis
Symptoms of gastroenteritis
Complications of gastroenteritis
Causes of gastroenteritis
How is gastroenteritis spread?
Diagnosis of gastroenteritis
Treatment of gastroenteritis
Prevention of gastroenteritis

HAbout gastroenteritis

In the UK, about one in five people get an infection causing gastroenteritis each year. It’s more common in babies and young children who may have it more than once in a year. If you have gastroenteritis, it generally goes without you needing medical treatment. If a baby or a young child has gastroenteritis it can be more dangerous because he or she becomes dehydrated more easily.

Your stomach and bowels are known collectively as your gastrointestinal tract – or gut. Gastroenteritis is an infection of your gut. You can get an infection by eating or drinking food that is contaminated with bacteria, viruses or parasites, or from other people with an infection. Bacteria, viruses and parasites can damage the cells lining the inner surface of your gut and stop it working as it should.

Certain bacteria or viruses may also produce poisons called toxins that can irritate your gut and cause it to produce excess fluid. This can cause the symptoms of gastroenteritis, such as diarrhoea.

Symptoms of gastroenteritis

The time between catching the infection and the start of symptoms (the incubation period) depends on the type of infection you have. It can range from one hour to a few weeks but it’s most often between one and three days.

You may have symptoms including:

diarrhoea, which may contain blood and mucus, or be watery, greasy or frothy
feeling sick or being sick
abdominal (tummy) cramps, bloating or pain
a fever

The time it takes to recover depends on what infection you have. Most people recover within approximately 10 days. However, severe infections, which are uncommon in the UK, may last for many weeks. It's important to go to your GP if your symptoms last for more than a week, or if you have recently travelled abroad.

In adults and older children, the symptoms of gastroenteritis may be confused with other conditions, such as irritable bowel syndrome (IBS), Crohn's disease or ulcerative colitis.

Complications of gastroenteritis

Complications from gastroenteritis occur mainly in young children or if you are over 65, have chronic gastroenteritis or a weakened immune system.

Possible complications of gastroenteritis include:

dehydration
malnutrition
irritable bowel syndrome (IBS) may occur later on

Contact your GP if:

you have severe pain or it doesn't respond to over-the-counter painkillers
the vomiting or diarrhoea continues for more than a few days or you can't drink or eat without being sick
there is blood or mucus in your diarrhoea
you have signs of dehydration, including a very dry mouth, muscle cramps, reduced urine, sunken eyes and, later, confusion or irritability
you have recently travelled abroad
you can't take medicines you usually take for other conditions without being sick

Causes of gastroenteritis

The main causes of gastroenteritis are infection with a virus, bacteria or parasite.

Viruses

Viruses are a main cause of gastroenteritis, particularly in children. These include:

rotavirus
norovirus
enteric adenovirus
hepatitis A

Viral infections can be seasonal. There is a peak of rotavirus and norovirus infections during the winter months.

Bacteria

The most common cause of bacterial gastroenteritis is food poisoning. Different bacteria that cause food poisoning include Salmonella, Campylobacter and Escherichia coli (E. coli).

Parasites

Parasites rarely cause gastroenteritis in the UK, but are a major problem in less-developed countries and you may get infected when abroad.

How is gastroenteritis spread?

The infections are transmitted:

in contaminated food
from person to person – this happens if an infected person goes to the toilet and doesn't wash their hands properly afterwards, before handling food or touching other people
when an individual infected with a virus sneezes or coughs, as another person could inhale the virus
in shellfish harvested from polluted waters
in contaminated drinking water – in less-developed countries this is how the majority of infections occur

Diagnosis of gastroenteritis

Your GP will ask about your symptoms and examine you. He or she may ask about your medical history. It’s important to tell your GP if you have been travelling and which countries you have visited and any vaccinations you have had. Your GP may ask you for a sample of faeces (stool sample) to send for laboratory testing.

Treatment of gastroenteritis

Self-help and diet

If you have gastroenteritis you usually stay at home until your symptoms get better.

The most important thing you should do is replace the fluids and salts you have lost, to prevent dehydration.

If you have mild gastroenteritis, drinks such as water and squash will help keep you hydrated. You can continue to eat as usual, but you shouldn't have foods, particularly fatty or spicy foods, or fizzy drinks, until you have recovered.
If you have a more severe infection, use an oral re-hydration solution (eg Dioralyte), which can be purchased from a pharmacist. This is a powder that is made up into a solution by adding water. It contains the right balance of sugars and salts for your body to encourage rehydration. Eat foods that are high in carbohydrates, such as rice or toast until you feel like you can eat as usual. Salty foods such as soup can help replace salt lost from your body.

Probiotics (foods containing live, beneficial bacteria) can help to reduce the duration of diarrhoea.

If your baby has gastroenteritis and you’re breastfeeding, continue to breastfeed and give oral rehydration as well, if needed. A child with gastroenteritis will need to be drinking enough first before you encourage him or her to start eating again.

Medicines

Medicines to stop diarrhoea such as loperamide (eg Imodium) are only recommended for adults. These medications slow down bowel movements, but have no effect on the excess fluid. Diarrhoea is only prevented temporarily until you stop taking these medicines, then the excess fluid will be passed as diarrhoea. However, they are useful if you absolutely need to travel and won’t be near a toilet.

Your GP may prescribe a medicine to help you stop being sick called an anti-emetic. Anti-emetics can be helpful if you have severe vomiting. If you’re in pain, take an over-the-counter painkiller, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Gastroenteritis caused by viruses can’t be treated with antibiotics. Your GP won't usually prescribe antibiotics for gastroenteritis. However, if your GP suspects that you have a bacterial infection, he or she may ask you for a faeces sample to send for laboratory testing, particularly if you have been travelling recently. The results will help to determine if you need antibiotics.

Hospital treatment

If you have lost so much fluid that you’re very dehydrated, hospital treatment may be needed to replace fluids directly into your bloodstream via a catheter into your vein (intravenously).

Prevention of gastroenteritis

The best way to prevent gastroenteritis is to always wash your hands with soap after going to the toilet and to disinfect toilets after use. It’s also important to practise good food hygiene.

Make sure you have any necessary vaccinations before you travel to other countries and drink bottled water where necessary when abroad.

If you have gastroenteritis, you can help to prevent spreading the infection to others.

Hygienically dispose of, or properly clean, all soiled items such as towels or soiled nappies if your baby is ill.
Clean the toilet with disinfectant.
Don’t share towels and flannels.
Don’t prepare food for others.

If you have gastroenteritis you may be infectious to others. Stay away from work, school or college for at least 48 hours after your symptoms have stopped. Children shouldn’t go swimming for two weeks after the diarrhoea has stopped.

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

What are probiotics and how can they help if I have gastroenteritis?
Why are people who take antibiotics more prone to getting gastroenteritis?
How should I prepare food to avoid getting gastroenteritis or giving it to others?
How can I prevent my child from getting gastroenteritis when we're abroad?
I have gastroenteritis, what should I eat?
I have heard dehydration is a risk in children with gastroenteritis but how will I know?

What are probiotics and how can they help if I have gastroenteritis?

Probiotics are a food supplement. They contain live bacteria and yeasts that can be helpful in restoring the balance of bacteria in your gut after a bout of gastroenteritis. They are safe for children.

Explanation

Bacteria are often thought of as harmful and a cause of ill-health, but there are many good bacteria that live in and on your body that help keep you healthy. This is especially so in your gut. Good bacteria in your gastrointestinal tract prevent harmful organisms from growing in your bowel or entering your body through your bowel.

Gastroenteritis is a condition due to an infection in your gut caused by harmful bacteria, viruses or parasites. They damage the cells lining the inner surface of your gut interfering with its normal processes and upsetting the balance of bacteria. Taking probiotics that contain bacteria such as lactobacillus helps to restore the balance of good bacteria in your gut. This can relieve symptoms of diarrhoea and speed up your recovery.

You can buy probiotics as food supplements (capsules or tablets) from your pharmacist or health food shop. Always read the patient information leaflet that comes with your supplements. Some yoghurts or drinks (eg Danone Activa or Actimel) also contain probiotics and are available from supermarkets.

Probiotics tend to be useful for irritable bowel syndrome (IBS) or after gatroenteritis. However, there isn’t much scientific evidence to suggest that probiotic products have any benefit for healthy people.

If you have any questions about probiotics or gastroenteritis, talk to your pharmacist or GP.

Further information

The British Dietetic Association
0121 200 8080
www.bda.uk.com

Sources

Allen SJ, Okoko B, Martinez EG, et al. Probiotics for treating infectious diarrhoea. Cochrane Database of Systematic Reviews 2003, Issue 4 www.cochrane.org
Probiotics. The British Dietetic Association. www.bda.uk.com, accessed 14 March 2010
Gastroenteritis. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 10 March 2010
Diarrhoea: Can probiotics help? Informed Health Online. www.informedhealthonline.org, accessed 14 March 2010
Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press, 2010:427

Why are people who take antibiotics more prone to getting gastroenteritis?

Some antibiotics can upset the balance of good bacteria in your gut allowing harmful bacteria to thrive. This is often referred to as antibiotic-associated diarrhoea and can cause painful stomach cramps and watery diarrhoea.

Explanation

Antibiotics are medicines prescribed to treat infections (for example, a kidney infection). They are used to kill or prevent the growth of harmful bacteria in your body. However, some antibiotics, such as ampicillin, clindamycin and cephalosporins, will also kill the normal bacteria in your gut. This can allow other bacteria such as Clostridium difficile (C. difficile), to grow and thrive in your gastrointestinal tract. As this bacterium multiplies and divides, it produces a toxin which causes pain in your abdomen (tummy) and watery diarrhoea – known as gastroenteritis. This is also called antibiotic-associated diarrhoea.

It's not clear how many people get diarrhoea as a result of taking antibiotics. It has been estimated that it could be as many as one in four people, although the number may be much lower.

Most people who get antibiotic-associated diarrhoea have mild symptoms that go quickly. It's important to seek advice from your GP if you have symptoms rather than stopping the course of antibiotics yourself. If possible, he or she will take you off the antibiotic and prescribe a different type.

While you have symptoms, continue with your usual diet, but leave out fatty foods or sugary food and drinks. Make sure you drink enough fluids. If you have become dehydrated, you can take oral rehydration salts (eg Dioralyte). Taking probiotic supplements or yoghurt drinks can also be helpful in easing symptoms of diarrhoea.

Very occasionally, a C. difficile infection in your gut can develop into a serious disease and symptoms can be severe. If your diarrhoea doesn't improve and you’re in a lot of discomfort, see your GP. He or she may take a faeces sample and blood test for analysis before referring you for treatment.

If you have any questions about antibiotics or gastroenteritis, ask your pharmacist or GP.

Sources

Diarrhoea - antibiotic associated. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 14 March 2010
Gastroenteritis. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 10 March 2010
Probiotics. The British Dietetic Association. www.bda.uk.com, accessed 14 March 2010
Allen SJ, Okoko B, Martinez EG, et al. Probiotics for treating infectious diarrhoea. Cochrane Database of Systematic Reviews, 2003, Issue 4. www.cochrane.org
Diarrhoea: Can probiotics help? Informed Health Online. www.informedhealthonline.org, accessed 14 March 2010
Diarrhoea and vomiting in children under 5. National Institute for Health and Clinical Excellence (NICE), 2009, CG84. www.nice.org.uk

How should I prepare food to avoid getting gastroenteritis or giving it to others?

Gastroenteritis is often caused by poorly prepared or stored food. Following good food hygiene measures can ensure that you, and the people you cook for, don't become ill.

Explanation

To prevent gastroenteritis it's important to maintain hygiene standards when preparing, cooking and storing food. The following food hygiene tips will help you to keep yourself, and those you cook for, safe.

Preparing food

When preparing food it's important to make sure that bacteria aren't spread. To prevent this:

wash your hands before you start preparing food and after touching raw food (especially meat)
check the use-by dates on food and that they have been stored properly
prepare raw foods, and foods that are ready to eat, separately
clean knives and chopping boards thoroughly after using them to prepare raw meat
keep cloths, tea towels and hand towels clean and wash or dispose of them regularly
allow meat and poultry to thaw thoroughly before cooking

Cooking food

During cooking, any harmful bacteria in your food are destroyed so it's important to make sure you cook everything properly. Do this by:

making sure your food is hot all the way through before you eat it
never reheating food more than once

Storing food

Some foods need to be kept chilled in the fridge to keep them safe. When storing these types of food, always:

put them in the fridge straight away
cool cooked foods as quickly as possible before putting them in the fridge
use separate, sealed containers to store raw meat and poultry in your fridge
don't overfill your fridge, otherwise the cold air won't be able to flow properly and food may become too warm

If you have any questions or concerns about gastroenteritis and food hygiene, talk to your GP.

Further information

Food Standards Agency
www.eatwell.gov.uk

Sources

Gastroenteritis. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 10 March 2010
Preparing. Food Standards Agency. www.eatwell.gov.uk, accessed 14 March 2010
Cleaning. Food Standards Agency. www.eatwell.gov.uk, accessed 14 March 2010
Cooking. Food Standards Agency. www.eatwell.gov.uk, accessed 14 March 2010

How can I prevent my child from getting gastroenteritis when we're abroad?

Food hygiene standards aren’t always as high abroad as they are at home. Also, you may encounter bacteria that your child hasn’t been exposed to before. But by being prepared and careful about what your child eats and drinks while you’re away, you can ensure that your child stays healthy.

Explanation

For most children who get gastroenteritis, the symptoms are usually mild and clear up fairly quickly without treatment. Getting gastroenteritis while abroad can be unpleasant and distressing for both you and your child and interferes with your time away. To make sure your child stays well, it's important that he or she is careful when eating and drinking. To reduce the risks while on holiday, try to do the following.

Ensure you child has any suggested vaccinations in enough time for your trip. Your GP or travel clinic will have an up-to-date list of these for the area you’re visiting and when they need to be given.
Only drink bottled water and check that the seal isn’t broken when you buy it. Use bottled water for brushing teeth too. Try not to have ice in drinks if you don't know where the water came from.
Eat fruits that you can peel first and try not to eat salad leaves unless you have washed them yourself in bottled or sterilised water.
Be cautious with shellfish and eggs (especially raw eggs in foods like mayonnaise) which are a common source of salmonella abroad.

Before travelling abroad, it's important to think about what you can take with you in case your child does become ill. Oral rehydration salts (eg Dioralyte) can be extremely useful if your child becomes dehydrated. It's important to use clean, safe drinking water when preparing the solution. If you don't have any oral rehydration salts you can give your child sports drinks (eg Lucozade). Probiotic supplements can also be useful in relieving symptoms.

If you have any questions or concerns about gastroenteritis and you will be travelling, talk to your travel health advisor, GP or pharmacist before you go abroad.

Further information

The National Travel Health Network and Centre (NaTHNaC)
www.nathnac.org

Sources

Gastroenteritis. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 10 March 2010
Storing and preparing. Food Standards Agency. www.eatwell.gov.uk, accessed 14 March 2010
Allen SJ, Okoko B, Martinez EG, et al. Probiotics for treating infectious diarrhoea. Cochrane Database of Systematic Reviews 2003, Issue 4. www.cochrane.org
Diarrhoea: Can probiotics help?. Informed Health Online. www.informedhealthonline.org, accessed 14 March 2010

I have gastroenteritis, what should I eat?

If you have gastroenteritis, it's important to continuing to eat as normal and drink enough fluids.

Explanation

You can continue to eat as usual, but you shouldn't have fatty foods, such as chips, fast foods, crisps and cakes or spicy foods until you have recovered. Eat foods that are high in carbohydrates, such as rice, toast, dry cereal or crackers until you feel like you can return to your usual diet. Salty foods such as soup can help replace salt lost from your system. You may find that having small meals often rather than large meals less often helps while you recover.

It’s very important to stay hydrated. If you have a mild case of gastroenteritis, drinks such as water and squash should be enough – don’t drink fizzy drinks until you have recovered. If you have a more severe infection, use an oral rehydration solution (eg Dioralyte), which you can purchase at a pharmacy. The rehydration solution contains a powder that is made up into a solution by adding water with the right balance of sugars and salts for your body. Always read the patient information leaflet that comes with the solution.

Probiotics (foods containing live, beneficial bacteria) can help to reduce the duration of diarrhoea.

If you have any concerns or questions about gastroenteritis, talk to your pharmacist or GP.

Further information

The British Dietetic Association

0121 200 8080
www.bda.uk.com

Food Standards Agency

www.eatwell.gov.uk

Sources

Gastroenteritis. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 10 March 2010
Allen SJ, Okoko B, Martinez EG, et al. Probiotics for treating infectious diarrhoea. Cochrane Database of Systematic Reviews 2003, Issue 4. www.cochrane.org

I have heard dehydration is a risk in children with gastroenteritis but how will I know?

The main risk of gastroenteritis in children is that he or she may become dehydrated. There are a number of symptoms of dehydration. If your child has these symptoms, you must seek medical help.

Explanation

In babies and young children, gastroenteritis can be more dangerous because he or she becomes dehydrated more easily. This can occur quickly in babies because of the size of a baby. He or she doesn’t need to lose much fluid to lose a significant amount of their total body fluid. Symptoms of dehydration in children include:

lack of energy or sleepiness
being irritable
loss of skin elasticity – when gently pinched the skin doesn’t immediately spring back into position
the soft spot on the scalp (called the fontanelle) may be sunken in young babies
dry lips and mouth
sunken eyes
fewer tears when crying than usual
fewer wet nappies than usual – due to less urine being made by the baby’s kidneys
pale or patchy (mottled) skin
fast heart rate
rapid, shallow breathing
cold fingers and toes – when gently squeezed, blood (pinkness of fingers and toes) takes a long time to return

Contact your GP if your child is becoming dehydrated, or if there is a possibility that their illness isn’t a gut infection.

Sources

Diarrhoea and vomiting in children under 5. National Institute for Health and Clinical Excellence (NICE), 2009, CG84. www.nice.org.uk
Pediatrics, gastroenteritis. emedicine. www.emedicine.medscape.com, accessed 14 March 2010
Dehydration. emedicine. www.emedicine.medscape.com, accessed 14 March 2010